Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 5/2014

01-11-2014 | Gynecologic Oncology

Undifferentiated uterine sarcoma: a rare, not well known and aggressive disease: report of 13 cases

Authors: Iván Ríos, Ángeles Rovirosa, Javier Morales, Blanca Gonzalez-Farre, Meritxell Arenas, Jaume Ordi, Jaume Pahisa, Albert Biete

Published in: Archives of Gynecology and Obstetrics | Issue 5/2014

Login to get access

Abstract

Purpose

Undifferentiated uterine sarcomas (UUS) are rare and aggressive tumor with scarce data on the outcome and best treatment. We aimed to describe the behavior among patients with UUS at our institution.

Materials and methods

Thirteen patients with UUS treated in our centre from 1979 to 2010 were analyzed. Statistics: descriptive analysis for frequencies and Kaplan–Meier actuarial method for overall survival (OS).

Results

Patients mean age was 66 years. Three had FIGO 2009 stage IA, five IB, two IIB, and three IVB. Ten patients underwent surgery and eight received postoperative radiotherapy. Three patients received adjuvant chemotherapy. The median follow-up was 16 months (2–276 months). Stage I patients developed two local relapses and three distant metastases (DM). DM was also observed in stage II patients and in 61.5 % of the entire series. Fifty percent of patients receiving radiotherapy remain alive without relapse. The median OS was 16 months, being 17 months for stage I and 9 for the remainder.

Conclusions

Poor outcome of UUS was associated with a high incidence of DM. Stage I had the best outcome. Radiotherapy seems to have benefited patients, with 100 % of local control and 50 % of long-term survivors. The high incidence of metastasis suggests the need for more accurate initial assessment.
Literature
1.
go back to reference Harlow BL, Weiss NS, Lofton S (1986) The epidemiology of sarcomas of the uterus. J Natl Cancer Inst 76:399–402PubMed Harlow BL, Weiss NS, Lofton S (1986) The epidemiology of sarcomas of the uterus. J Natl Cancer Inst 76:399–402PubMed
2.
go back to reference Gadducci A, Sartori E, Landoni F, Zola P, Maggino T, Cosio S et al (2002) The prognostic relevance of histological type in uterine sarcomas: a Cooperation Task Force (CTF) multivariate analysis of 249 cases. Eur J Gynaecol Oncol 23:295–299PubMed Gadducci A, Sartori E, Landoni F, Zola P, Maggino T, Cosio S et al (2002) The prognostic relevance of histological type in uterine sarcomas: a Cooperation Task Force (CTF) multivariate analysis of 249 cases. Eur J Gynaecol Oncol 23:295–299PubMed
3.
go back to reference Hendrickson MR, Tavassoli FA, Kempson RL (2003) Mesenchymal tumours and related lesions. In: Tavassoli FA, Deville P (eds) Pathology and genetics of tumours of the breast and female organs. IARC, Lyon, pp 233–244 Hendrickson MR, Tavassoli FA, Kempson RL (2003) Mesenchymal tumours and related lesions. In: Tavassoli FA, Deville P (eds) Pathology and genetics of tumours of the breast and female organs. IARC, Lyon, pp 233–244
4.
go back to reference Kurihara S, Oda Y, Ohishi Y, Iwasa A, Takahira T, Kaneki E et al (2008) Endometrial Stromal Sarcomas and Related High-grade Sarcomas: immunohistochemical and molecular genetic study of 31 Cases. Am J Surg Pathol 32:1228–1238PubMedCrossRef Kurihara S, Oda Y, Ohishi Y, Iwasa A, Takahira T, Kaneki E et al (2008) Endometrial Stromal Sarcomas and Related High-grade Sarcomas: immunohistochemical and molecular genetic study of 31 Cases. Am J Surg Pathol 32:1228–1238PubMedCrossRef
5.
go back to reference Xue W-C, Cheung ANY (2011) Endometrial stromal sarcoma of uterus. Best Pract Res Clin Obstet Gynaecol 25:719–732PubMedCrossRef Xue W-C, Cheung ANY (2011) Endometrial stromal sarcoma of uterus. Best Pract Res Clin Obstet Gynaecol 25:719–732PubMedCrossRef
6.
go back to reference Tanner EJ, Garg K, Leitao MM, Soslow RA, Hensley ML (2012) High grade undifferentiated uterine sarcoma: surgery, treatment, and survival outcomes. Gynecol Oncol 127:27–31PubMedCrossRef Tanner EJ, Garg K, Leitao MM, Soslow RA, Hensley ML (2012) High grade undifferentiated uterine sarcoma: surgery, treatment, and survival outcomes. Gynecol Oncol 127:27–31PubMedCrossRef
7.
go back to reference Ning L, Ling-Ying W, Hong-Tu Z, Ju-Sheng A, Xiao-Guang L, Shao-Kang M (2008) Treatment options in stage I endometrial stromal sarcoma: a retrospective analysis of 53 cases. Gynecol Oncol 108:306–311CrossRef Ning L, Ling-Ying W, Hong-Tu Z, Ju-Sheng A, Xiao-Guang L, Shao-Kang M (2008) Treatment options in stage I endometrial stromal sarcoma: a retrospective analysis of 53 cases. Gynecol Oncol 108:306–311CrossRef
8.
go back to reference Chang KL, Crabtree GS, Lim-Tan SK, Kempson RL, Hendrickson MR (1990) Primary uterine endometrial stromal neoplasms. a clinicopathologic study of 117 cases. Am J Surg Pathol 14:415–438PubMedCrossRef Chang KL, Crabtree GS, Lim-Tan SK, Kempson RL, Hendrickson MR (1990) Primary uterine endometrial stromal neoplasms. a clinicopathologic study of 117 cases. Am J Surg Pathol 14:415–438PubMedCrossRef
9.
go back to reference Klaus B, Barbara BA, Andreas O, Windbichler G, Petru E, Mayerhofer S et al (2001) Prognostic parameters in endometrial stromal sarcoma: a clinicopathologic study in 31 patients. Gynecol Oncol 81:160–165CrossRef Klaus B, Barbara BA, Andreas O, Windbichler G, Petru E, Mayerhofer S et al (2001) Prognostic parameters in endometrial stromal sarcoma: a clinicopathologic study in 31 patients. Gynecol Oncol 81:160–165CrossRef
10.
go back to reference Valduvieco I, Rovirosa A, Colomo L, De San Juan A, Pahisa J, Biete A (2010) Endometrial stromal sarcoma. is there a place for radiotherapy? Clin Transl Oncol 12(3):226–230PubMedCrossRef Valduvieco I, Rovirosa A, Colomo L, De San Juan A, Pahisa J, Biete A (2010) Endometrial stromal sarcoma. is there a place for radiotherapy? Clin Transl Oncol 12(3):226–230PubMedCrossRef
12.
go back to reference Zagouri F, Domopoulos A-M, Fotiou S, Kouloulias V, Papadimitriou A (2009) Treatment of early uterine sarcomas: disentangling adjuvant modalities. World J Surg Oncol 7:38–48PubMedCrossRefPubMedCentral Zagouri F, Domopoulos A-M, Fotiou S, Kouloulias V, Papadimitriou A (2009) Treatment of early uterine sarcomas: disentangling adjuvant modalities. World J Surg Oncol 7:38–48PubMedCrossRefPubMedCentral
13.
go back to reference Rovirosa A, Ascaso C, Ordi J, Abellana R, Arenas M, Lejarcegui JA et al (2002) Is vascular and lymphatic space invasion a main prognostic factor in uterine neoplasms with a sarcomatous component? a retrospective study of prognostic factors of 60 patients stratified by stages. Int J Radiat Oncol Biol Phys 52(5):1320–1329PubMedCrossRef Rovirosa A, Ascaso C, Ordi J, Abellana R, Arenas M, Lejarcegui JA et al (2002) Is vascular and lymphatic space invasion a main prognostic factor in uterine neoplasms with a sarcomatous component? a retrospective study of prognostic factors of 60 patients stratified by stages. Int J Radiat Oncol Biol Phys 52(5):1320–1329PubMedCrossRef
14.
go back to reference Schick U, Bolukbasi Y, Thariat J (2012) Outcome and prognostic factors in endometrial stromaltumors: a rare cancer network study. Int J Radiation Oncol Biol Phys 82(5):757–763CrossRef Schick U, Bolukbasi Y, Thariat J (2012) Outcome and prognostic factors in endometrial stromaltumors: a rare cancer network study. Int J Radiation Oncol Biol Phys 82(5):757–763CrossRef
15.
go back to reference Chew I, Oliva E (2010) Endometrial stromal sarcomas. a review of potential prognostic factors. Adv Anat Pathol 17(2):113–121PubMedCrossRef Chew I, Oliva E (2010) Endometrial stromal sarcomas. a review of potential prognostic factors. Adv Anat Pathol 17(2):113–121PubMedCrossRef
16.
go back to reference Rovirosa A, Ascaso C, Ordi J, Arenas M, Valduvieco I, Lejarcegui JA et al (2009) How to deal with prognostic factors and radiotherapy results in uterine neoplasms with a sarcomatous component? Clin Transl Oncol 11(10):681–687PubMedCrossRef Rovirosa A, Ascaso C, Ordi J, Arenas M, Valduvieco I, Lejarcegui JA et al (2009) How to deal with prognostic factors and radiotherapy results in uterine neoplasms with a sarcomatous component? Clin Transl Oncol 11(10):681–687PubMedCrossRef
17.
Metadata
Title
Undifferentiated uterine sarcoma: a rare, not well known and aggressive disease: report of 13 cases
Authors
Iván Ríos
Ángeles Rovirosa
Javier Morales
Blanca Gonzalez-Farre
Meritxell Arenas
Jaume Ordi
Jaume Pahisa
Albert Biete
Publication date
01-11-2014
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 5/2014
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-014-3311-8

Other articles of this Issue 5/2014

Archives of Gynecology and Obstetrics 5/2014 Go to the issue